Editorial: A health-care emergency

Saturday

Feb 28, 2009 at 12:01 AMFeb 28, 2009 at 2:34 AM

The federal government announced this week that Americans will pay an average of $8,160 per capita this year for health care, an increase of $356 per person over last year. That is a lot of money by any measure, but it is even larger in comparison to what the rest of the world pays.

The federal government announced this week that Americans will pay an average of $8,160 per capita this year for health care, an increase of $356 per person over last year.

That is a lot of money by any measure, but it is even larger in comparison to what the rest of the world pays. The most recent comparison comes from the United Nations, which estimated in 2007 Americans paid $6,096 per person for health care. Switzerland that year paid $4,011 per person; Canada $3,173; United Kingdom $2,560; Japan $2,293; Israel $1,972.

Looked at through another measure, the U.S. pays 16 percent of gross domestic product on health care, which also tops the world. But by no measure are we getting our money's worth. The World Health Organization ranks the United States 37th in health outcomes. We fall well behind similar nations in such measures as life expectancy, infant mortality and immunization.

Americans are paying more, and getting less. And, while most other industrialized nations provide health care for all their citizens, 45 million Americans lack health insurance, a number the Congressional Budget Office estimates will grow to 54 million within a decade.

The out-of-pocket costs are just the beginning. American companies that provide employee health insurance are bogged down by rising costs, making it harder to compete globally. U.S. auto companies, for instance, have expanded in Canada while retracting in the U.S., because Canadians get their health insurance through the government.

Then there are the costs our health-care system imposes that are harder to quantify but even more far-reaching. How much economic dynamism is lost because people choose not to change jobs or start businesses because they can't afford to lose their health coverage? How much market advantage do good businesses lose because they cover their employees while their competitors don't?

There's no shortage of suspects when it comes to health-care inflation: administrative expenses added by the private insurance bureaucracy; defensive medicine practiced by physicians, a lack of incentives for patients to price-shop; lack of preventive care; overuse of emergency rooms; expensive end-of-life care; poor utilization of information technology; duplication, mistakes and waste.

It all adds up to a convincing argument that health-care reform is not only a moral imperative, it is an economic one. It also means that cost containment must be as large a part of the health-reform debate as covering the uninsured.

The conclusion that the current system is economically unsustainable has brought players to the table that resisted previous efforts to reform the system, including large and small business, the medical community and even pharmaceutical companies.

The winds of reform are blowing strong in Congress, where Sen. Ted Kennedy, though slowed by his own poor health, is determined to cap his historic career with the health reform he has pursued for 40 years. And we now have a president who refuses to let multiple crises on other fronts keep him from keeping his promise to fix the health-care system.

"Health-care reform cannot wait, must not wait and will not wait another year," Barack Obama told a joint session of Congress on Tuesday. It won't be easy, but America simply can no longer afford to let what ails our health-care system fester.